||Introduction: Midlife, which encompasses the menopause transition in women, can be a time of disrupted sleep and accelerated atherosclerosis accumulation.
Short or poor sleep quality has been associated with cardiovascular disease (CVD) risk; few studies have investigated relations among midlife women. We
tested whether shorter actigraphy sleep time or poorer subjective sleep quality was associated with carotid atherosclerosis among midlife women.
Aims and Methods: Two hundred fifty-six peri- and postmenopausal women aged 40–60 years completed 3 days of wrist actigraphy, hot flash monitoring,
questionnaires (Pittsburgh Sleep Quality Index [PSQI], Berlin), a blood draw, and carotid ultrasound [intima media thickness (IMT), plaque]. Associations of
objective (actigraphy) and subjective (PSQI) sleep with IMT/plaque were tested in regression models (covariates: age, race, education, body mass index, blood
pressure, lipids, insulin resistance, medications, snoring, depressive symptoms, sleep hot flashes, and estradiol).
Results: Shorter objective sleep time was associated with higher odds of carotid plaque (for each hour shorter sleep, plaque score ? 2, odds ratio (OR) [95%
confidence interval, CI] = 1.58 [1.11–2.27], p = .01; plaque score = 1, OR [95% CI] = 0.95 [0.68–1.32], p = .75, vs. no plaque, multivariable). Poorer subjective
sleep quality was associated with higher mean IMT [?, b (standard error, SE) = 0.004 (0.002), p = .03], maximal IMT [b (SE) = 0.009 (0.003), p = .005], and
plaque [plaque score ? 2, OR (95% CI) = 1.23 (1.09–1.40), p = .001; score = 1, OR (95% CI) = 1.06 (0.93–1.21), p = .37, vs. no plaque] in multivariable models.
Findings persisted additionally adjusting for sleep hot flashes and estradiol.
Conclusions: Shorter actigraphy-assessed sleep time and poorer subjective sleep quality were associated with increased carotid atherosclerosis among
midlife women. Associations persisted adjusting for CVD risk factors, hot flashes, and estradiol.